MEDICARE: DR. JENNY KA-YEE MAK O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	7295T	TX

General Provider Information

NPI Number	:	1649435827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNY KA-YEE MAK O.D.

Provider Business Mailing Address
First Line	:	2423 WROXTON RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-1435
Country	:	US
Telephone Number	:	469-835-2914
Fax Number	:

Provider Business Practice Location Address
First Line	:	5307 FM 1960 RD W STE B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-4417
Country	:	US
Telephone Number	:	281-440-5887
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2008
Last Update Date	:	06/23/2010

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